211:. In addition to the challenges of graying, declining and poverty-stricken populations, as well as the preference of privately insured patients to seek treatment at newer hospitals further away, the report said corporate profit-driven decisions, as opposed to local community needs, shuttered the doors of rural hospitals in underserved areas. In a "shift from mission to margin," health systems that owned multiple hospitals, some more profitable than others, closed less-profitable hospitals in Kentucky and South Carolina to concentrate resources on other hospitals in the chain, resulting in communities without acute care and emergency facilities to serve as a safety-net for patients facing challenges with mental health and drug use. The case studies report also notes that decreases in Medicare and Medicaid reimbursements, some the result of federal budget sequestration or across the board cuts, others the result of the Affordable Care Act's lower hospital Medicare readmission reimbursement rates, negatively impacted the finances of the rural hospitals.
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rely for financial stability, reimburses at higher rates than
Medicare. Proponents argue, however, that proposed single-payer legislation in the House and Senate would boost hospital reimbursements far beyond current levels, while establishing annual global hospital funds that could be increased to cover unexpected costs and grant applications for capital improvements. Supporters of single-payer point to the closure of over 100 rural hospitals since 2010, with over 400 also at risk of closure, as evidence of the failure of a for-profit health insurance system unaffordable to many rural residents and unsustainable for hospitals that rely on reimbursements from private insurance.
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health insurance, retirement packages, sabbaticals, sign-on bonuses, low-interest home loans. The Indian Health
Service (IHS) offers prospective doctors up to $ 40,000 for repayment of student loans in exchange for a two-year commitment to serve American Indian and Alaska Native communities. Similarly, the National Health Service Corps (NHSC) offers up to $ 50,000 toward loan repayment if licensed health care providers agree to practice for two years in an underserved area. Under the federal NIMHD Loan Repayment Program (LRP) health professionals with doctoral degrees can receive up to $ 50,000 per year for two years to conduct research on health disparities.
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insurance. Critics who support single-payer instead charge that offering a public option to compete with private insurance would create a two-tiered system of concierge versus minimal medical services, as private for-profit insurance companies use political muscle to deny coverage to the oldest and sickest
Americans, thus shunting the more expensive patients onto a financially vulnerable public option. Medicare for All proponents also say a hybrid system of private insurance coupled with a public option would result in added bureaucracy and paperwork, and therefore fail to lower health care costs.
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164:(CDC) reports that during 1999â2014 rural counties experienced increased mortality rates from the five leading causes of death (1-heart disease, 2-cancer, 3-unintentional injury, 4-chronic lower respiratory disease (CLRD), 5-stroke) compared with metropolitan counties. Unintentional injuries (high speed car accidents; opioid and drug abuse and traumatic brain injuries) mortality rates, were "approximately 50% higher in rural areas than urban areas", with lack of access to adequately staffed healthcare facilities listed as one among several factors leading to this disparity.
535:(CMS), explains wage index disparities between urban and rural hospitals that led to underfunding rural hospitals will no longer strictly determine Medicare and Medicaid reimbursements. Under new policy rules, struggling rural hospitals may be eligible for higher Medicare reimbursements which, according to CMS, can be used to attract more highly skilled medical professionals. In addition, CMS will expand rural telehealth services under Medicare Advantage, a privatized insurance program, and relax supervision requirements for physician assistants and radiologist assistants.
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this barrier by establishing licensed micro-hospitals with eight to ten inpatient beds in underserved regions. Another obstacle to growth of FECs in underserved areas is the preference of for-profit health systems to place FECs in dense urban communities that will attract more patients and generate more money while replacing hospital-based emergency services and primary care. Advocates of the FEC model for hard-pressed communities argue the federal government should expand the recognition of independent FECs as
Medicare and Medicaid participants in underserved areas.
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rates in underserved communities. Backers of single-payer or
Medicare for All note that minorities and the poor, as well as rural residents, in general, are less able to afford private health insurance, and that those who can must pay high deductibles and co-payments that threaten families with financial ruin. In addition, they argue that those with employment-based insurance are tethered to jobs for fear of losing their medical coverage while rural communities with high unemployment lose out on job-based insurance benefits.
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to treat more patients, boost testing and obtain protective gear, even arrange for a plane from billionaire Warren
Buffett's company to fly in masks from China, while a Brooklyn public hospital serving patients predominantly poor and of color resorts to plastic and duct tape to separate infectious patients' quarters and launches a Go Fund Me page to raise money for masks, gowns and booties to protect doctors and nurses from a virus that is "killing black and Latino New Yorkers at about twice the rate of white residents."
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broadband internet necessary for successful implementation of telehealth. A survey conducted in 2019 found that people living in rural areas are twice as likely to not have access to the internet connection than urban counterparts. Additionally, lack of internet access was more prevalent among the elderly population and within racial and ethnic minority communities, which could contribute to the existing disparities in accessing care.
642:
435:, a landmark ruling that barred the use of public funds to expand segregated hospitals. Still, racial segregation in the medical field persists, with African Americans living in black neighborhoods more likely than whites to undergo treatment at hospitals with higher surgical death rates, give birth at hospitals with higher neonatal mortality rates and live in nursing homes with fewer staff members and tenuous finances.
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living on or near reservations and in rural areas concentrated in Alaska and the western United States. In 2011, the IHS reported that life expectancy for Native
Americans was 73, compared to 78 for all other races in the US, as Native Americans and Alaskan natives were dying at higher rates due to chronic liver disease, diabetes, intentional self-harm and suicide, as well as respiratory diseases. In 2016, the
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residence. Proponents say telehealth or remote medical attention can provide patients in health care deserts with greater access to specialists unavailable in rural communities while encouraging patients to assume a greater role in managing their own health care and improving communication between them and their team of doctors. For example, with telehealth a diabetic patient might:
300:(OIG) issued reports criticizing the IHS's hospital care for tribal members, citing lack of oversight, outdated equipment and difficulty in recruiting and retaining skilled staff. Administrators at one hospital interviewed by the OIG complained of aging hospital infrastructure with corroded pipes causing sewage to spill into an operating room.
613:, a think tank advocating limited government, advocates for removal of federal obstacles in order to classify telehealth as preventative care under high deductible insurance plans, provide reimbursements for telehealth visits equal to in-person doctor visits and permit doctors licensed in one state to practice telemedicine across state lines.
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poverty, exceeding the numbers in urban centers and rural areas and straining hospitals with aging infrastructure. Additionally, the Health
Affairs study noted large numbers of uninsured or Medicaid-reliant suburban dwellers either can't find doctors and hospitals who will serve them or must travel great distances to see specialists.
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For example, in parts of rural Alaska, transferring patients to hospital emergency rooms can "depend on the schedules of rickety charter planes" which are often prevented from flying due to the weather. In some states, such as
Oklahoma, a lack of available residency programs for prospective doctors directly contributes to a shortage.
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there is a higher ratio than in urban areas. Those over 65 years old are also more likely to require medical services for chronic conditions such as hypertension and heart disease. Living in a rural medical desert for older adults, then, could mean less of a chance to be able to receive treatment for such chronic conditions.
64:. Racial demographic disparities in healthcare access are also present in rural areas, particularly in Native American communities which experience worse health outcomes and barriers to accessing quality medical care. Limited access to emergency room services, as well as medical specialists, leads to increases in
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Critics of telehealth argue on-line doctor visits are no substitute for in-person evaluations which can provide a more accurate diagnosis and that uninsured rural
Americans still won't be able to afford quality medical care. In addition, they argue large swaths of rural America may not have access to
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Proponents of a national health insurance program to replace for-profit health insurance argue adoption of a federally funded single-payer system allowing patients to choose their own doctor would reduce "structural racism" in health care that results in non-white Americans suffering higher mortality
384:
During the COVID-19 crisis, New York Times reporter Michael Schwirtz wrote (April 26, 2020) of the disparities in hospital services and finances between New York's white communities and those of color, with a private hospital closer to Wall Street able to tap reserves and exercise political influence
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fatalities due to multiple factors, including greater exposure in use of public transportation and employment in care-giving, sanitation and retail, underlying health conditions, as well as lack of access to nearby medical health clinics and hospitals and inadequate health insurance. In an April 2020
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While approximately 20% of Americans live in rural regions, only 9% of the country's doctors practice in rural areas. The average age of doctors in rural areas has increased, with over 50% of rural physicians over the age of 50. In 2019, it was predicted that the number of rural doctors would decline
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oversees the non-profit National Rural Recruitment and Retention Network to connect medical professionals, hospitals and clinics in rural areas with recruitment and retention resources. The Network lists the following incentives rural legislative and medical entities could offer prospective doctors:
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community have argued, however, that the government chronically under funds the IHS, resulting in a lack of accessible health care facilities, particularly emergency room departments for those living on reservations. The IHS provides services to 573 tribes and 2.56 million Native Americans primarily
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The lack of entertainment or food diversity, fear of prejudice, and reduced financial prospects associated with rural regions have been cited as factors leading to medical students' reluctance to practice in rural regions, as well as the unique difficulties associated with practice rural healthcare.
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There is a disproportionately higher population of older adults over 65 who live in rural areas, with 17.5% of rural populations being over 65 versus 13.8% in urban areas. This means that medical deserts in rural areas have a more significant impact on the older adult population in rural areas since
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is limited, as there are approximately 5.1 primary care doctors per 10,000 people, whereas there are 8.0 doctors per 10,000 in urban centers. About 8% of rural counties had no doctors in 2019. Rural communities face lower life expectancy and increased rates of diabetes, chronic disease, and obesity.
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FECs can function as outpatient departments for existing hospitals or as independently owned entities. One obstacle to the establishment of additional independently run FECs is the inability to receive Medicare and Medicaid reimbursements afforded only to licensed hospitals. Some FECs have overcome
538:
On the state level, in 2016 Georgia established a $ 60 billion tax credit program to allow hospital donors to write off 100% of their donation to support a rural hospital. An investigation by the state's Department of Audits and Accounts found, however, the donations were not benefiting the rural
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Critics of Medicare for All oppose a government funded health care system, wanting to preserve a for-profit model to increase competition, and assert that hospitals, already financially vulnerable in rural America, would lose more money and risk bankruptcy because private insurance, on which they
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Proponents of a public option support expanding the Affordable Care Act to give consumers a choice; private for-profit health insurance or Medicare. Backers of the public option say the ACA has not gone far enough, noting that despite the United States spending a greater percentage of its GDP on
455:
Though suburbs often conjure images of affluence, a Health Affairs study using national survey data from 2005 to 2015 belies that picture. According to the survey, the suburbs, receiving a fraction of public health care funding compared to cities, are home to 17 million Americans who struggle in
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expansionâestimated at $ 100 billion federal dollars over 10 yearsâthen Texas Governor Rick Perry told Tea Party supporters in 2013, "Texas will not be held hostage by the Obama administration's attempt to force us into this fool's errand of adding more than a million Texans to a broken system."
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To address the rural health care crisis, advocates of telehealth promote the use of digital information and communication technologyâcell phones and computersâthat can be accessed from home or work without encumbering the patient with long travel times to hospitals at least 60 miles from their
553:
In light of large numbers of hospital closures, particularly in rural America where the lack of emergency room services spawn health care deserts, proponents of 24-hour free standing emergency centers (FECs) advocate for more FECs that, unlike Urgent Care centers, would expand offerings beyond
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with one-million residents and the highest mortality rate in the county, also has the highest rates of disease and premature deaths from preventable conditions: "coronary heart disease, homicide, diabetes, lung cancer, and motor vehicle crashes." In economically stressed South LA, there are 11
195:ârural Americans face limited options as hospitals close their doors. A 2019 study found that participation in Medicaid expansion reduced the likelihood of rural hospital closures by 62% and that of the hospitals deemed most at-risk for closure, 75% were in states that did not expand Medicare.
518:
While advocates of a public option agree with single-payer proponents that the United States should provide universal health care, they disagree on the solution, asserting that Americans are not interested in a government-run health care system and want to be able to keep their private health
446:
The 2010 passage of the Affordable Care Act expanded Medicaid eligibility for low income Americans, but several Southern states with large poor black populations opted out of the expansion, its Republican governors opposing the Obama-led initiative as federal over-reach. In rejecting Medicaid
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in large US citiesâChicago, Los Angeles, New York Cityâare more likely than white majority neighborhoods to be located in trauma care deserts that are greater than five miles from a trauma center offering emergency medical services and specialists: neurosurgeons, cardiac doctors, respiratory
423:
in 2008, Ronald M. Davis, MD, past president of the American Medical Association (AMA), apologized for the organization's history of excluding African-Americans from the AMA, pledging to "right the wrongs perpetrated against African American physicians, their families and patients."
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found that the percentage of rural Americans enrolling in medical school is declining. A 2023 survey of physicians found that 68% of newly graduated doctors wanted to work in hospitals, rather than jobs in family practices that are more common in rural areas. Additionally, only 4% of
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by 23% by 2030 due to these physicians retiring. An additional contributing factor to this decline is newly graduated doctors' reluctance to move to rural areas. Doctors originally from rural areas are more likely to practice in rural regions, however, a study from the
79:
Between 2010-2021, 136 hospitals in rural regions closed their doors, unable to bear worker shortages, low patient volume, and financial burdens of the COVID-19 pandemic. In addition to the immediate financial problems facing rural healthcare providers, inequities in
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Rural residents may live on farms, ranches and Indian reservations far from a hospital, forcing residents to take several hours or an entire day off work to drive to a doctor's appointment or follow up care, making rural residents less likely to seek treatment. The
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Fewer than half of rural women live within a thirty-minute drive of the nearest hospital able to provide obstetric services, and 12% do not live within a sixty-minute drive of the nearest such hospital, resulting in increased maternal and infant mortality rates.
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Even as health care delivery models shift from hospitals to community clinics offering Urgent Care in once-vacant retail spaces, poor neighborhoods face inequities with the distribution of community clinics in predominantly wealthier suburban neighborhoods.
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hospitals that need the funds the most because too much money was deposited in the bank accounts of third party partners. Lawmakers have also complained that tax credits have benefited at least one rural hospital with a $ 60 million profit margin.
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In New Mexico, where Native Americans, in 2020, make up six percent of the population but 25% of positive COVID-19 cases, members of the Navajo Nation live without access to running water to frequently wash their hands, as recommended by the CDC.
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health care than any other nation, there are still over 28-million people without health insurance, resulting in Americans in underserved communities dying for lack of affordable care or declaring bankruptcy because of mounting medical bills.
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Those favoring a strictly for-profit health care model claim a public option, with lower hospital reimbursements than private insurance, would bankrupt rural hospitals dependent on higher reimbursements from commercial insurance vendors.
198:
In 2016, the Kaiser Commission on Medicaid and the Uninsured, in conjunction with the Urban Institute, conducted a case study analysis of three privately owned Southern hospitals to determine the causes and effects of their closures in
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pediatricians for every 100,000 children, whereas in upscale West Los Angeles there are almost 200 pediatricians for every 100,000 children. In West LA, 12 percent of adults are uninsured compared to 30 percent in South LA.
377:
analysis of early data, the Washington Post found that counties with a majority of Black residents faced three times the rate of COVID-19 infections and almost six times the rate of deaths as majority white counties.
411:, with medical schools perpetuating stereotypes of racial inferiority up until the mid 20th century and scientists exploiting African Americans in unethical experimentation without informed consent. Journalist
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coverage, are less likely to live within an hour of a hospital emergency room. Although concentrated in rural regions, health care deserts also exist in urban and suburban areas, particularly in predominantly
442:
Former Texas Governor Rick Perry speaking at a Republican leadership conference in 2013. Perry opposed Medicare expansion under the Affordable Care Act, resulting in Texas opting out of the expansion.
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A team of researchers found that in Los Angeles 89 percent of Black-majority census tracts were situated in trauma deserts; in Chicago, 73 percent; in New York City 14 percent. In Los Angeles County,
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that led to racially segregated clinics, doctors' offices and hospitals in which African Americans were assigned to separate wings to receive inferior medical treatment. In a 2008 address to the
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Hundreds of years of geographical segregation left a legacy of segregated and understaffed hospitals serving African American communities. In a departure from the past, the
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327:, where, according to government investigators, patients died as a result of misdiagnoses and treatment by staff members not screened for hepatitis and tuberculosis.
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have demanded greater control over hospital administration. In July, 2019, the Great Plains Tribal Chairman's Health Board representing 18 tribal communities in
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Carr, Brendan G.; Bowman, Ariel J.; Wolff, Catherine S.; Mullen, Michael T.; Holena, Daniel N.; Branas, Charles C.; Wiebe, Douglas J. (February 2017).
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reimbursements and tax credits for struggling hospitals; the establishment of strategically placed free-standing emergency centers; the expansion of
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Pines, Jesse M.; Ernst, David (February 21, 2017). "Solving The Rural Health Care Access Crisis With The Freestanding Emergency Center Care Model".
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Garcia, Macarena C.; Faul, Mark; Massetti, Greta; Thomas, Cheryll C.; Hong, Yuling; Bauer, Ursula E.; Iademarco, Michael F. (January 13, 2017).
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381:(AMA), noting structural inequities gripping communities of color, urged the federal government to collect COVID-19 data by race and ethnicity.
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are further aggravated by the disproportionately low amount of newly graduated doctors that are willing to work in rural areas. Addressing the
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Sept. 13, 2017. Senator Bernie Sanders (I-VT) speaks in favor of Medicare for All. Senator Kirsten Gillibrand (D-NY) is standing to his left.
27:, with those locations featuring inadequate access to one or more kinds of medical services. An estimated thirty million Americans, many in
2307:"Single-Payer Health Reform: A Step Toward Reducing Structural Racism in Health Care | Harvard Public Health Review: A Student Publication"
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96:(AAMC) projected a shortage of between 37,800 and 124,000 physicians, which impact rural and underserved communities the most directly.
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Reynolds, P. Preston (June 1, 1997). "Hospitals and Civil Rights, 1945-1963: The Case of Simkins v Moses H. Cone Memorial Hospital".
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BrĂŽnzac, Monica G; Kuhlmann, Ellen; Dussault, Gilles; Ungureanu, Marius I; CherecheČ, RÄzvan M; Baba, CÄtÄlin O (October 10, 2023).
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Access an on-line patient portal to view test results, request pharmacy prescriptions, email a doctor or schedule an appointment
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identified nearly 80 percent of rural America as âmedically underserved,â lacking in skilled nursing facilities, as well as
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Tung, Elizabeth L.; Hampton, David A.; Kolak, Marynia; Rogers, Selwyn O.; Yang, Joyce P.; Peek, Monica E. (March 1, 2019).
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wanted to work in a community of 25,000 or less, highlighting the difficulty in recruiting new physicians to rural areas.
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and telemedicine to remote areas; and increased incentives to recruit doctors to practice in rural and underserved areas.
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Smith, David Barton; Feng, Zhanlian; Fennell, Mary L.; Zinn, Jacqueline S.; Mor, Vincent (September 2007).
905:"A Historical Perspective of Healthcare Disparity and Infectious Disease in the Native American Population"
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1466:"A Look at Rural Hospital Closures and Implications for Access to Care: Three Case Studies - Issue Brief"
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Cai, Christopher; Kahn, James (December 9, 2019). "Medicare For All Would Improve Hospital Financing".
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Americans, Institute of Medicine (US) Committee on the Future Health Care Workforce for Older (2008),
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1282:"Reducing Potentially Excess Deaths from the Five Leading Causes of Death in the Rural United States"
1225:"Reducing Potentially Excess Deaths from the Five Leading Causes of Death in the Rural United States"
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2829:"Recruitment and Retention for Rural Health Facilities Introduction - Rural Health Information Hub"
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Use a cell phone to upload food diaries and blood sugar levels for review by medical professionals
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36:
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Dissatisfied with the IHS's management of health clinics and hospitals closest to reservations,
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2143:"Separate And Unequal: Racial Segregation And Disparities In Quality Across U.S. Nursing Homes"
69:
2623:"Trump Administration Finalizes Policies to Advance Rural Health and Medical Innovation | CMS"
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Skinner, Lucy; Staiger, Douglas O.; Auerbach, David I.; Buerhaus, Peter I. (July 25, 2019).
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According to research conducted in 2019 by University of Chicago Medicine, African American
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1440:"A Look at Rural Hospital Closures and Implications for Access to Care: Three Case Studies"
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2574:"The Potential Impact of a Medicare Public Option on U.S. Rural Hospitals and Communities"
2332:"How would Medicare for All address our rural health crisis: Sample Letters to the Editor"
8:
2554:"The Difference Between a 'Public Option' and 'Medicare for All'? Let's Define Our Terms"
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804:"Disparities in access to trauma care in the United States: A population-based analysis"
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2017:
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Wishner, Jane; Solleveld, Patricia; Paradise, Julia; Antonisse, Larisa (July 7, 2016).
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Wishner, Jane; Solleveld, Patricia; Paradise, Julia; Antonisse, Larisa (July 7, 2016).
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Scholars and researchers trace the roots of African American health care inequities to
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Download an app to estimate, based on diet and activity, the amount of insulin needed.
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The federal government is legally obligated under treaties to provide medical care to
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2209:"Health Care In The Suburbs: An Analysis Of Suburban Poverty And Health Care Access"
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In states that chose not to expand Medicaid programs under the Affordable Care Actâ
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1009:"2023 Survey of Final Year Medical Residents: Many Job Choices, Many Reservations"
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Health Professional Shortage Areas map from the U.S. Federal Government, June 2020
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Proposed solutions to US health care deserts include the enactment of a national
1792:"Mayors, governor call out racial health disparities highlighted by coronavirus"
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979:"AHA report: Rural hospital closures threaten patient access to care | AHA News"
953:"Healthcare Access in Rural Communities Overview - Rural Health Information Hub"
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1961:"Who gets hospitalized for Covid-19? Report shows differences by race and sex"
1888:"Healthcare Deserts Being Left Behind As Systems Expand Care Into Communities"
1127:"Supply and Distribution of the Primary Care Workforce in Rural America: 2019"
1102:"Availability of healthcare providers in rural areas lags that of urban areas"
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2649:"Report: State's tax credit program falls short for neediest rural hospitals"
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2776:"Telehealth Use in Rural Healthcare Overview - Rural Health Information Hub"
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2751:"Heritage Recommendations Influence Administration's Telemedicine Guidance"
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2001:"Race, medicine, and health care in the United States: a historical survey"
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2406:"Text - S.1129 - 116th Congress (2019-2020): Medicare for All Act of 2019"
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1981:"One Rich N.Y. Hospital Got Warren Buffett's Help. This One Got Duct Tape"
2353:"Rural Hospitals Say 'Medicare For All' Would End Up 'Closing Our Doors'"
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Supporters demand a Public Option be included in the Affordable Care Act.
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1817:"Indian Country faces higher risks, lack of resources in COVID-19 fight"
1772:"Fed Up With Deaths, Native Americans Want to Run Their Own Health Care"
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744:"Defining medical desertsâan international consensus-building exercise"
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Receive email reminders to obtain a flu shot or other preventative care
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Watch a video on carbohydrate counting to better control glucose levels
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1842:"Study: Urban African-Americans more likely to live in trauma deserts"
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2380:"H.R.1384 - 116th Congress (2019-2020): Medicare for All Act of 2019"
2256:"Growing number of suburban poor discover health care's nowhere land"
1414:"1 in 4 rural hospitals is vulnerable to closure, a new report finds"
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2675:"Lawmakers want limits on profits allowed in rural hospital program"
2455:"453 rural hospitals are failing â Medicare for All would save them"
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1030:"To overcome doctor shortage, get rid of obstacles to primary care"
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Retooling for an Aging America: Building the Health Care Workforce
1148:"Rural Health Disparities Overview - Rural Health Information Hub"
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Higher medical reimbursements and tax credits for rural hospitals
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2598:"Rural Health at CMS: What's Been Done and What's to Come | CMS"
1913:"Why African-Americans may be especially vulnerable to COVID-19"
1590:"Attracting the next generation of physicians to rural medicine"
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2183:"Texas Politicians And Businesses Feud Over Medicaid Expansion"
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2527:"OPINION: Don't be fooled, a public option is no single payer"
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1199:"Health Disparities Affect Millions in Rural U.S. Communities"
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Schnake-Mahl, Alina S.; Sommers, Benjamin D. (October 2017).
1699:"For Native Americans, Health Care Is A Long, Hard Road Away"
1646:"Oklahoma is a physician 'desert,' state medical leader says"
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US Health Professional Shortage Areas (Facilities), June 2020
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2804:"How might internet connectivity affect health care access?"
1941:"4 reasons coronavirus is hitting black communities so hard"
1751:"Why Care at Native American Hospitals Is Often Substandard"
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Video conference with a doctor or other medical professional
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Pre-arranged transfer for patients requiring hospitalization
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Areas with limited access to healthcare in the United States
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Park, Annie; Watson, Nancy; Galloway-Gilliam, Lark (2008).
856:"Race/Ethnicity and Geographic Access to Urban Trauma Care"
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African Americans account for a disproportionate number of
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National Association for the Advancement of Colored People
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of the country, live at least a sixty-minute drive from a
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2074:"The history of African Americans and organized medicine"
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Native Alaskan children standing in front of their homes.
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with trauma care services. Regions with higher rates of
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Herzlinger, Regina; Boxer, Richard (October 10, 2019).
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Cohen, Steven A.; Greaney, Mary L. (November 9, 2022).
1174:"Maternal Health Care Is Disappearing in Rural America"
903:
Ehrenpreis, Jamie E.; Ehrenpreis, Eli D. (April 2022).
431:(NAACP) in the 1960s won a US Supreme Court victory in
2692:
2509:"The Case for the Public Option Over Medicare for All"
853:
1620:"Would You Want to Move to a Remote Alaskan Village?"
801:
289:
United States Department of Health and Human Services
2140:
1544:"Implications of an Aging Rural Physician Workforce"
1081:"National Healthcare Quality and Disparities Report"
902:
637:
388:
2206:
1978:Schwirtz, Michael; Luce, Kirsten (April 26, 2020).
1388:"Health Status and Health Care Service Utilization"
621:
Incentives to recruit skilled medical professionals
1742:
2869:
558:Advanced laboratory equipment (x-rays; CT scans)
2506:
2040:
2038:
2036:
1490:Rosenblatt, R. A; Hart, LG (November 1, 2000).
2048:"Why American Health Care Is Still Segregated"
1489:
496:Public option to the Affordable Care Act (ACA)
368:COVID-19 impacts on urban communities of color
259:Impact on Native Americans and Alaskan Natives
23:has many regions which have been described as
2033:
1977:
1328:
1088:U.S. Department of Health and Human Services
909:The American Journal of the Medical Sciences
533:Centers for Medicare & Medicaid Services
2550:
2005:Journal of the National Medical Association
1998:
1871:"South Los Angeles Health Equity Scorecard"
1056:"Rural Health: Addressing Barriers to Care"
718:Maternity care deserts in the United States
2854:"Loan Forgiveness for Medical School Debt"
2726:"Managing your health in the age of Wi-Fi"
2701:
1999:Byrd, W. M.; Clayton, L. A. (March 2001).
976:
465:Single-payer healthcare / Medicare for All
162:Centers for Disease Control and Prevention
88:remains a challenge in terms of improving
2571:
2551:Sanger-Katz, Margot (February 19, 2019).
2158:
2016:
1672:"Basis for Health Services | Fact Sheets"
1515:
1385:
1362:
1305:
1256:
928:
879:
827:
775:
549:Emergency department § Free standing
433:Simkins v Moses H. Cone Memorial Hospital
2592:
2590:
2112:10.7326/0003-4819-126-11-199706010-00009
2097:
1758:. The Associated Press. October 9, 2016.
1696:
1612:
1610:
505:
478:
437:
346:
270:
262:
249:
236:Association of American Medical Colleges
218:
98:
94:Association of American Medical Colleges
92:. In the 2010s, a study released by the
2429:
2403:
2377:
2044:
1789:
849:
847:
708:Physician shortage in the United States
229:Physician shortage in the United States
68:and long-term health problems, such as
2870:
2478:
2452:
2378:Jayapal, Pramila (December 10, 2019).
1958:
1768:
1616:
1222:
543:Free standing emergency centers (FECs)
214:
2798:
2796:
2672:
2646:
2587:
2253:
1937:
1864:
1862:
1607:
1537:
1535:
1470:The Henry J. Kaiser Family Foundation
1411:
459:
43:patients, as well those who lack any
2045:Newkirk, Vann R. II (May 18, 2016).
1003:
1001:
999:
844:
561:Emergency trained doctors and nurses
450:
395:Race and health in the United States
2404:Sanders, Bernard (April 10, 2019).
1959:Cooney, Elizabeth (April 9, 2020).
13:
2808:Peterson-KFF Health System Tracker
2793:
2254:Korry, Elaine (January 31, 2018).
1859:
1697:Friedman, Misha (April 13, 2016).
1532:
1412:Scott, Dylan (February 18, 2020).
1134:WWAMI Rural Health Research Center
567:Prolonged 24-hour observation care
531:Seema Verma, Administrator of the
267:Indian Health Service (IHS) Banner
14:
2894:
2712:10.1377/forefront.20170221.058847
2673:Nolin, Jill (February 15, 2019).
2647:Nolin, Jill (December 12, 2019).
2440:10.1377/forefront.20191205.239679
1790:Beavers, David (April 12, 2020).
1769:Walker, Mark (October 15, 2019).
1171:
996:
872:10.1001/jamanetworkopen.2019.0138
748:European Journal of Public Health
389:Racial disparities in health care
334:
281:American Indian and Alaska Native
130:
2453:Jordan, Chuck (March 11, 2020).
1617:Khazan, Olga (August 28, 2014).
682:
668:
654:
640:
379:The American Medical Association
2878:Healthcare in the United States
2846:
2821:
2768:
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2640:
2615:
2565:
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2500:
2479:Saslow, Eli (August 17, 2019).
2472:
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2397:
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2273:
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2200:
2175:
2134:
2091:
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1992:
1971:
1952:
1931:
1905:
1880:
1834:
1809:
1783:
1762:
1716:
1690:
1664:
1638:
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1548:New England Journal of Medicine
1483:
1457:
1431:
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1394:, National Academies Press (US)
1379:
1322:
1273:
1216:
1191:
1165:
1140:
1119:
1094:
1073:
703:Healthcare in the United States
2281:"Health Care In Rural America"
1492:"Physicians and rural America"
1048:
1022:
970:
945:
896:
735:
119:(ACA); the approval of higher
1:
2482:"The 'follow-up appointment'"
2311:harvardpublichealthreview.org
1650:www.beckershospitalreview.com
728:
627:Office of Rural Health Policy
575:
323:, took over the Rapid City's
2078:American Medical Association
1335:Current Epidemiology Reports
1331:"Aging in Rural Communities"
1286:MMWR. Surveillance Summaries
1229:MMWR. Surveillance Summaries
1223:Garcia, Macarena C. (2017).
1034:American Medical Association
820:10.1016/j.injury.2017.01.008
713:Poverty in the United States
421:National Medical Association
7:
2883:Social problems in medicine
2581:American Health Care Future
2100:Annals of Internal Medicine
1724:"Disparities | Fact Sheets"
1496:Western Journal of Medicine
921:10.1016/j.amjms.2022.01.005
698:Health in the United States
633:
502:Publicly funded health care
298:Office of Inspector General
86:doctor shortage in the U.S.
10:
2899:
1347:10.1007/s40471-022-00313-9
579:
546:
499:
468:
392:
226:
2225:10.1377/hlthaff.2017.0545
2160:10.1377/hlthaff.26.5.1448
554:primary care to include:
103:Rural farmland in America
2704:Health Affairs Forefront
2572:Goldsmith, Jeff (2019).
2432:Health Affairs Forefront
2285:Center for Rural Affairs
1846:www.uchicagomedicine.org
109:single payer health care
2833:www.ruralhealthinfo.org
2780:www.ruralhealthinfo.org
2755:The Heritage Foundation
2513:Harvard Business Review
1152:www.ruralhealthinfo.org
957:www.ruralhealthinfo.org
611:The Heritage Foundation
471:Single-payer healthcare
1938:Scott, Eugene (2020).
1508:10.1136/ewjm.173.5.348
1298:10.15585/mmwr.ss6602a1
1241:10.15585/mmwr.ss6602a1
760:10.1093/eurpub/ckad107
511:
484:
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283:Americans through the
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111:system; adoption of a
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2531:Indiana Daily Student
509:
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285:Indian Health Service
274:
266:
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222:
102:
90:healthcare in America
2011:(3 Suppl): 11Sâ34S.
1652:. September 19, 2019
1560:10.1056/NEJMp1900808
690:United States portal
475:Medicare for All Act
409:institutional racism
291:. Advocates for the
149:intensive care units
2487:The Washington Post
1946:The Washington Post
1178:Scientific American
287:(IHS), part of the
241:resident physicians
215:Physician shortages
117:Affordable Care Act
2559:The New York Times
1986:The New York Times
1777:The New York Times
1756:The New York Times
1172:Maron, Dina Fine.
512:
485:
460:Proposed solutions
444:
353:
325:Sioux San Hospital
277:
269:
256:
225:
137:federal government
105:
2679:The Daily Citizen
2359:. August 16, 2019
2287:. August 22, 2007
2219:(10): 1777â1785.
1730:. January 1, 2013
1678:. January 1, 2013
860:JAMA Network Open
451:In suburban areas
357:South Los Angeles
351:South Los Angeles
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1919:. April 10, 2020
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153:rural healthcare
82:rural healthcare
45:health insurance
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401:chattel slavery
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66:mortality rates
52:communities in
25:medical deserts
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2147:Health Affairs
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1554:(4): 299â301.
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1036:. June 1, 2022
1021:
1016:AMN Healthcare
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335:In urban areas
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141:rehabilitation
132:
131:In rural areas
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